Join one of the fastest-growing behavioral healthcare companies in the industry!!
Founded in 1995, New Directions helps people live healthy, balanced lives. New Directions provides managed behavioral health services, an Employee Assistance Program, Student Assistance Program, organizational consulting and health coaching to private and public health plans, Fortune 100 companies, large and medium employers and labor groups.
Role and Responsibilities :
- Demonstrates a high level of knowledge of insurance benefits and products
- Documents clear, accurate and timely information
- Verifies demographic information and authenticates the contact
- Understands laws and New Directions policy and process around release of information
- Provides benefits and eligibility information with research within one or more systems to provide the most accurate information
- Provides information on claims questions depending on book of business and if claims information is available to view i.e. payment date, amount paid, claim pending, denial reason, allowable information and cost sharing, no claim on file. Refers to Claims Specialist for more complex claim inquiries.
- Provides routine referral to outpatient services specific to the person's requirement i.e. male/female/ specialty/training/geographic location/product.
- Triage callers to clinical staff as needed for assistance. i.e. caller in crisis, tearful, or needing referral for a higher level of care
- Able to work simultaneously between multiple systems to provide member/provider behavioral health benefits.
- Consistently meets individual goals for attendance, ready time, incoming calls, documentation and quality.
- Adheres to New Directions Behavioral Health Mission Statement, Core Values, Code of Business Conduct, and Compliance Program.
- Complies with all Federal and applicable State laws and New Directions Behavioral Health Policies regarding, privacy, confidentiality, and security of health information, and other designated information.
- High School Diploma +5 years of customer service experience, or Associates degree and 3 years of customer service experience or Bachelor's degree; preferred Bachelor's degree in healthcare related field
- Excellent oral and written communication skills and an ability to communicate effectively with all levels of the organization
- Excellent reasoning abilities and experience with coordinating projects
- Highly organized, quick learner, detail oriented
- Ability to work independently and as part of a productive team
- Ability to hand multiple and conflicting priorities
- Works with a professional demeanor under pressure
- Must be able to work with minimal supervision
- Proficient with Microsoft Office (Word, Excel, Power Point and Outlook
- Preferred Spanish proficiency, but not required
- Preferred 5+ years customer service/call center experience
- Preferred 2+ years medical billing/coding and/or claims experience (mental health field preferred)
- Working knowledge of health insurance as a whole
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.